Chronic hepatitis B virus (HBV) infection causes substantial morbidity, with up to 40% of infected individuals developing cirrhosis, hepatocellular carcinoma, or liver failure. Approximately 25% of individuals with chronic hepatitis B will die prematurely from these complications. Hepatitis B vaccines are safe and more than 90% effective in preventing infection in at-risk adults, yet only approximately 25% of US adults for whom vaccination is recommended by the Centers for Disease Control and Prevention are vaccinated. The rate of new HBV infections dropped substantially in the United States after the introduction and high uptake of hepatitis B vaccines in infants and children, and the burden of disease has shifted primarily to adults. There has been a resurgence of hepatitis B cases in US adults in recent years, with sharp increases in new cases noted in states highly impacted by the opioid epidemic. Improved hepatitis B vaccination coverage rates in US adults can help slow the rate of acute infections and reduce the reservoir of infection in US adults.